Individual
MR. FREDRICK EARL WORTHY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC/L
Contact information
Practice address
400 BORDER AVE E, WIGGINS, MS 39577-2822
(601) 928-5492
Mailing address
328 STILLWAY DR, WIGGINS, MS 39577-2902
(601) 503-0824
(601) 928-6874
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0152
MS
Other
Enumeration date
04/10/2006
Last updated
07/08/2007
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